The Abortion Clinic Evaluation Project
by Sharon Lieberman
The on-site
evaluation of Chicago's abortion clinics was a pro-choice, feminist
endeavor, beginning in 1973 with the founding of the Health Evaluation
and Referral Service (HERS) by several women of the Chicago Women's
Liberation Union. HERS responded to a need made apparent by the Roe
v. Wade decision legalizing abortion: Where in Chicago were the medically
competent, most humane providers and the most financially accessible
services? At the time, a major goal was identify providers willing to
accept Medicaid payment for abortion.
Cooperation and
participation of freestanding women's health clinics - those self-identified
as dedicated primarily to outpatient abortion services - with the consumer-led
evaluations was voluntary. Pairs of HERS women would visit a clinic,
looking for facility and care standards they could recommend. HERS
produced several mimeographed lists and pamphlets of approved providers
that were circulated among women's organizations and used as a referral
list to direct women who phoned HERS for a referral, all without a
fee. An essential aspect of the referral service was the solicitation
of feedback from women who attended a referred clinic. All callers
were asked to return an anonymous written evaluation from so that HERS
could always be apprised of consumer responses to the approved clinics.
A 1978 combined undercover investigation by the Better Government Association
and the Chicago Sun-Times revealed several large, exploitative abortion referral
agencies and medically dangerous abortion practitioners in Chicago.
In response, HERS formalized and structured the on-site evaluation:
HERS and Planned Parenthood/Chicago Area (PP/CA) negotiated a cooperative
activity of clinic evaluation to be conducted on a bi-annual basis.
The two groups came to a written agreement on the minimum medical
and counseling standards for an approved provider. The original HERS consumer-lead,
feminist focused visits became professionalized.
The first cooperative
evaluation commenced in 1981, with two representatives of HERS and
two from PP/CA visiting clinics to which they were invited. PP/CA
provided a physician, experienced in abortion procedures, who evaluated
actual terminations. The major aspects of abortion provision - counseling,
surgical procedure, aftercare, and clinic administration - were observed
directly by each evaluation team member with an interest and/or credentials
in that service. Fact-finding reports from the teams were evaluated
separately by each organization (HERS and PP/CA), with each developing
its own list, although most approved referral lists were similar.
The combined effort, from inception to referral list, took about
two years.
PP/CA removed
itself from the evaluation project in 1984 when it purchased the
Midwest Clinic. In becoming an abortion provider, PP/CA felt it could
no longer officially participate in evaluating other Chicago clinics.
For the Clinic
Evaluation Project of 1985-86, HERS secured funding and hired a part-time
Evaluation Coordinator to carry out the second bi-annual cycle. The
Chicago Community Trust underwrote development of evaluation instruments
by The Chicago Associates for Social Research for each clinic service
area observed by members of Evaluation Team.
The 1989-90
cycle took nearly three years to produce an approved provider list.
It became more difficult to recruit and train volunteers willing
to take the half-day needed to spend three hours at a clinic. Furthermore,
the core of volunteer evaluators- many early HERS founders, supporters,
and members -- from the earliest cycles had dispersed or moved on
to other feminist activities; and, a certain complacency about abortion
services was apparent within the pro-choice community.
A new corps
of volunteers had to be recruited for the 1989-90 cycle. During this
time, HERS encountered financial difficulties, closing its doors
permanently in late 1990. The Chicago Abortion Fund recognized the
value of the Clinic Evaluation Project to Chicago's women and so
accepted its sponsorship until clinic visits were completed and an
approved provider list was distributed in 1991.
The last of
what was known as the "HERS" evaluation was conducted in 1995-97, sponsored
by the Illinois Pro-Choice Alliance with funding from five local foundations.
The HERS Abortion Clinic Evaluation was the country's only on-site
evaluations of abortion clinics lead by an independent, non-profit,
feminist, consumer organization.
Sharon Lieberman was a member of the Abortion Clinic Evaluation
Project.
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